The must-read stories and debate in health policy and leadership.

A significant problem

The good news for system leaders is NHS Providers says it now accepts the case for ditching the four-hour target.

The bad news for Simon Stevens et al. is the lobby group has not yet backed system leaders’ replacement proposals due to significant concerns around accountability and deliverability, as its chief executive set out exclusively in an HSJ interview.

NHS Providers’ intervention comes with NHS England/Improvement hoping to publish the final recommendations of its clinical standards review (CSR), which has considered the future of accident and emergency targets alongside other measures. The changes don’t yet have ministerial sign-off.

The Royal College of Emergency Medicine also now backs ditching the four-hour target. But its president admitted in a recent HSJ interview it isn’t clear how the new bundle of emergency care metrics could be used as a public and transparent measure of how the NHS is performing, as the four-hour target has been.

Back in March Mr Hopson told HSJ there also needed to be a “legitimate currency converter” to compare “future performance against historical [four-hour] data”. “There would be a very significant problem,” if this was not possible, he said.

The CSR’ report detailing its final recommendations has much to address on the question of accountability. Without credible answers, there will indeed be a “significant problem”.

“Drafting error” sparks LGBTQ backlash

The NHS’ flagship People Plan has had to be amended after a section implied that being lesbian, gay, bisexual, transgender or queer counts as a disability.

NHS England’s chief people officer Prerana Issar lamented the “drafting error”, which she says has since been corrected following criticism from trust chief executives and senior policy leads on social media.

The error has undoubtedly hurt some staff even if the mistake was genuine, judging by online responses to the document. However, others feel the moment has been “weaponised” at a time when equality and diversity is vital.